Total ankle replacement: the effect on gait and physical activity – a prospective 1 year follow up study

M. Douglas-Harris, J. Ramaskandhan, K. Smith, S. Galloway, M. Siddique

Introduction: Total Ankle Replacements (TAR) is performed to optimise biomechanical function and facilitate improved mobility. However, there is little data on how spatiotemporal parameters and activity levels change post-surgery. We aimed to study improvement in Gait parameters and its association with Physical activity in patients who underwent TAR.

Methods: This was a prospective observational clinical study carried out with ethics permission and approvals for a single centre cohort. Patients who underwent TAR during the period of 2015 – 2018 were approached for study participation. Spatio-temporal parameters were measured by instrumented Gait Analysis (Tekscan TM Walkway system) with a recording of 6 x 5 meter walking trials preoperatively and 1-year post op. Patients completed a questionnaire containing the International Physical Activity Questionnaire (IPAQ). The change between pre and post-operative values was calculated and tested for significance.

Results: 10 patients were recruited for the study. Mean age of patients were 70.4 years. There were improvement in spatiotemporal and IPAQ parameters as whole group changes in one measurement domain did not achieve statistical significance (P=<0.05). However, there were areas where subject specific changes in spatiotemporal data positively correlated with IPAQ data changes. This was in the area of bilateral stride time (Pearsons = 0.9074 and 0.9109) (IPAQ 19) and stride length on the operated side (IPAQ 14) [0.7686], 15a [0.8564], 26 [0.932] and 27 [0.932]). These domains concerned increased days and hours spend doing vigorous physical activity outdoors and moderate physical activity indoors. Stride length was also positively correlated with time-spent sitting down.

Conclusion: TAR helps in improving Gait and Physical activity parameters in patients at 1 year post-operatively. There were subject specific changes in spatiotemporal data that meant it would not be appropriate to homogenise the data. There were positive correlations with bilateral stride time and operated stride length with physical activity measures.